Obstructive Disorders of the Esophagus

Most esophageal obstruction develops slowly and is incomplete when patients first seek care, typically for difficulty swallowing solids. However, sometimes complete esophageal obstruction develops suddenly because of an impacted esophageal foreign body or food bolus.

(See also Overview of Esophageal and Swallowing Disorders.)

Obstruction may have intrinsic or extrinsic causes.

Intrinsic obstruction may be caused by

• Foreign body impactions

• Esophageal tumors (benign esophageal tumors or esophageal cancer)

• Esophageal rings

• Esophageal webs

• Strictures caused by gastroesophageal reflux, eosinophilic esophagitis, or, rarely, caustic ingestion

Extrinsic obstruction may be caused by compression resulting from

• An enlarged left atrium

• An aortic aneurysm

• An aberrant subclavian artery (termed dysphagia lusoria)

• A substernal thyroid gland

• Cervical bony exostosis

• A thoracic tumor

For evaluation of potential esophageal obstruction, see Dysphagia.

Treatment of obstruction is directed at the specific cause. Emergent upper endoscopy is essential for patients with complete obstruction.